Individual provider Active NPI

Kathleen McCoy-Goldstein, FNP

  • Family Nurse Practitioner
  • Brookfield, CT
National Provider Identifier
1790707180
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
004847 Issued in CT
Practice address
60 Old New Milford Rd
Brookfield, CT 06804
Phone
(203) 775-6365
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X P330828-1 NY
Family Nurse Practitioner 363LF0000X 004847 CT Primary

Addresses

Primary practice location

60 Old New Milford Rd
Brookfield, CT 06804

Mailing address

60 Old New Milford Rd
Brookfield, CT 06804-2430
Phone (203) 775-6365

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120627000454 CT Practitioner - Nurse Practitioner 2062514441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

24 Hospital Ave
Danbury, CT 06810-6099
Phone (203) 739-7118

401 Federal Rd
Brookfield, CT 06804-2037
Phone (203) 775-6365

60 Old New Milford Rd
Brookfield, CT 06804-2430
Phone (203) 775-6365

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
004847CTMDClinical Social Worker
4847CTMDDentist
P330828-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice CT, Inc. CurrentSince Jun 18, 2012 Accepting new patients
Southbury Medical Associates, LLP Past Accepting new patients

Locations

401 Federal Rd
Brookfield, CT 06804
Phone (203) 775-6365

60 Old New Milford Rd
Brookfield, CT 06804
Phone (203) 740-2900

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1790707180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 OLD NEW MILFORD RD",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042430",
            "telephone_number": "203-775-6365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 OLD NEW MILFORD RD",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "06804",
            "telephone_number": "203-775-6365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY-GOLDSTEIN",
        "first_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "P330828-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "004847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, CT

Sources for this page

Verify at the official NPI Registry.